Detecção de HPV e presença de HIV vaginal em mulheres infectadas por HIV

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

Aim: To study factors associated to HPV and HIV vaginal viral load, including their correlation. Methods: This is a cross-sectional study with HIV- infected women. Those who were pregnant, had undergone histerectomy, using vaginal medication within the last 48 hours, had had unprotected sex less than 72 hours before, or had genital bleeding were excluded. An endocervical sample was used for Hybrid Capture II (HPV by HC II) to detect HPV (high and low risk), Chamydia trachomatis and N. gonorrhoeae. HPV types were identified by Linear Array (Roche), after viral DNA amplification. A cervico-vaginal lavage sample was obtained to determine free RNA-HIV load, using 10 mL of sterile normal saline. HIV vaginal and plasmatic viral loads were measured by HIV Monitor V 1.5 Cobas Amplicor. Prevalence ratios and respective 95% confidence intervals were calculated. RESULTS: Out of 201 women, 73.6% using ARV, 37.3% of women were identified with high or low risk HPV by HC II. Free HIV-RNA was detectable in cervical vaginal lavage of 9% of the cases. Higher HPV prevalence was associated with plasmatic HIV, lower T CD4 lynphocytes, combined hormonal contraceptives and cigarette smoking, but not with vaginal HIV-RNA. HPV by HC II was more prevalent in cases of cytologic or colposcopic abnormalities, but not ectopy, genital ulcerations, candidiasis or bacterial vaginosis. In over 80% of the samples, some type of HPV was detected (on average 3 types). The most prevalent types were HPV 62 (24.9%), 6 (19.4%), 53 (17.4%), 51 (14.9%), 61 (13.9%), 16 (12.9%) and 84 (11.4%). HPV 53, 51 and 16 (high risk) and 84 (undetermined) were associated to higher detection by HC II. The presence of more than three HPV types was the only factor which increased the prevalence of HPV by HC II in multivariate analysis. Using no ART, reduced CD4, plasma HIV viral load, and bacterial vaginosis increased the prevalence of vaginal HIVRNA, but plasmatic viral load was the only significant variable lin the multivariate analysis. CONCLUSIONS: HPV by HC II was detected in 37.5% of samples, and in 80% of the cases when Linear Array typing washed used. Having detectable vaginal RNA-HIV has not increased the prevalence of HPV detection. The prevalence of vagina RNA-HIV was 9%, well below the values found in the medical literature and associated to plasmatic viral load

ASSUNTO(S)

vagina - cancer aids (doença) hiv (virus) carga viral papilomavirus humano

ACESSO AO ARTIGO

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